Featured Research

Patients who are evaluated for liver diseases such as hepatitis C (HCV) are typically recommended for liver biopsy to determine the extent of disease progression. For patients who question whether less invasive testing is available, clinicians now have alternatives options to consider. Elastography and serum markers are two such diagnostic options.

Share This

Patients who are evaluated for liver diseases such as hepatitis C (HCV) are typically recommended for liver biopsy to determine the extent of disease progression. For patients who question whether less invasive testing is available, clinicians now have alternatives options to consider. Elastography and serum markers are two such diagnostic options reviewed in an editorial published in the June issue of Hepatology, a journal of the American Association for the Study of Liver Diseases.

Related Articles

Epidemiological studies report that approximately 150,000 individuals in the U.S. are diagnosed with chronic liver disease each year, and nearly 20% of these cases have cirrhosis at initial presentation. Complications from cirrhosis are determined by the extent and progression of fibrosis or scaring of the liver. Liver fibrosis, however, is not a linear process, but one that fluctuates with the influences of age, sex, race, alcohol exposure and obesity.

Liver biopsy remains the gold standard for determining activity and stage of fibrosis. However, this procedure has inherent limitations that include risk of pain or bleeding, inaccurate staging from sampling error, and variability of biopsy interpretation. With the increase in availability of sophisticated laboratory blood testing, the use of diagnostic liver biopsy is on the decline. "The drawbacks to liver biopsy have prompted researchers to investigate alternative, noninvasive markers for determining the severity of liver disease," said Dr. Jayant Talwalkar of the Mayo Clinic in Rochester, MN and editorial co-author.

Noninvasive screening with serum markers, or indicators in the blood, can identify patients at risk for liver fibrosis. Fibrotest, an indirect serum marker panel, is the most widely used and validated serum marker panel used worldwide. A number of studies have confirmed this panel to be reliable in detecting stage 4 fibrosis (cirrhosis) in patients with chronic HCV. Additional studies are underway to analyze its viability in hepatitis B, alcoholic liver disease, and nonalcoholic fatty liver disease.

Imaging techniques such as ultrasound-based transient elastography (TE) and magnetic resonance elastography (MRE) are noninvasive procedures that measure liver stiffness. Prior studies have found TE to be up to 90% accurate in diagnosing cirrhosis, and 70%-80% accurate in detecting stage 2 to stage 4 fibrosis. Evaluations of MRE have shown up to 85% accuracy for detecting intermediate to severe fibrosis (F2-F4). Currently only MRE is approved for use in the U.S.

"Noninvasive diagnostics are more advantageous to the patient as there are no serious side effects and they may be more cost effective when compared to liver biopsy although this remains to be determined," Dr. Talwalkar concluded. "Fibrotest or elastography imaging are helpful to confirm cirrhosis or minimal to no fibrosis. Liver biopsy may still be necessary to determine stage of fibrosis in those patients where noninvasive techniques were indeterminate."

Story Source:

The above story is based on materials provided by Wiley-Blackwell. Note: Materials may be edited for content and length.

Featured Research

Mar. 31, 2015  Researchers have illuminated an important distinction between mice and humans: how human livers heal. The difference centers on a protein called PPAR alpha which activates liver ... full story

Mar. 31, 2015  Researchers have recorded the first direct observations of the micro-scale mechanisms behind the ability of skin to resist tearing. The results could be applied to the improvement of artificial skin, ... full story

Mar. 31, 2015  Fewer than half of the physicians trained in the United States in 2013 received formal education or training on the subject of exercise, according to new research. "There are immense medical benefits ... full story

Mar. 31, 2015  Memory and as well as connections between brain cells were restored in mice with a model of Alzheimer's given an experimental cancer drug, researchers report. "With this treatment, cells under ... full story

Mar. 31, 2015  Increasing state alcohol taxes could prevent thousands of deaths a year from car crashes, say researchers, who found alcohol-related motor vehicle crashes decreased after taxes on beer, wine and ... full story

Mar. 31, 2015  Alcoholism takes a toll on every aspect of a person's life, including skin problems. Now, a new research report helps explain why this happens and what might be done to address it. "The clinical ... full story

Mar. 31, 2015  A new population of 'memory' immune cells has been discovered by scientists, throwing light on what the body does when it sees a microbe for the second time. This insight, and others like it, will ... full story

Mar. 31, 2015  Coronary heart disease and stroke, two of the leading causes of death in the United States, are diseases associated with heightened platelet reactivity. A new study in humans suggests an underlying ... full story

Mar. 31, 2015  A new study had researchers seeking answers to why the therapeutic benefit afforded by SSRIs was so limited in children and teenagers. If researchers can uncover the biological mechanisms preventing ... full story

Featured Videos

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015)  The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports.
Video provided by Reuters

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015)  Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline.
Video provided by Washington Post

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015)  Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17
Video provided by AFP

Jan. 10, 2012  A new classification for diagnosing fibrosis in patients with chronic hepatitis C virus has shown to be as accurate as currently used algorithms, but required no further liver ... full story

Apr. 12, 2010  Elasticity measurements have been reported to be useful for the diagnosis and differentiation of many tumors, which are usually harder than normal surrounding tissues. Recently, trans-abdominal ... full story

ScienceDaily features breaking news and videos about the latest discoveries in health, technology, the environment, and more -- from major news services and leading universities, scientific journals, and research organizations.